Winner CES 2026 · ISE 2026 · TMCnet 2026

AI Web Forms for Home & Senior Care. Online intake forms for home care agencies, answered at once.

AI Web Forms gives you online intake forms for home care agencies and senior living communities: the inquiry form, the referral form and the caregiver application each answer the moment they arrive. Details are checked, a contact is made, and the next step you chose follows, whether an assessment slot, a call back or an alert to intake.

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7 days free · per company, never per seat · nothing to install

Zanus AI · AI Web Forms · From form to follow-up

Online intake forms for home care agencies: five steps from the form to the follow-up plan, real Zanus AI screen

From form to follow-up

A family's form is checked, becomes a contact, gets the next step you chose and starts its follow-up, with the last 30 days counted on top.

Easy setupSet up everything just by talking to Lisa AISee how ›

You“Mark any referral that says discharge today as urgent and tell the intake nurse.”

Lisa“Referral forms that mention a discharge today will be marked URGENT, with an alert to the intake nurse. Apply?”

You talk. Lisa sets it up. Applied only on your yes.

How Home & Senior Care use it

A discharge planner's referral form arrives on Friday evening; a screening rule marks it urgent and the intake nurse is told at once.

A daughter fills in the inquiry form in Korean; the reply comes back in Korean with free assessment times from your booking page.

A caregiver applicant sends the careers form at midnight and receives your reply saying when the hiring coordinator will call.

REAL AI - the whole Front Office is AI, not old software with an AI button.

What’s included

Any form on your site, contact, quote, demo request, application, answered in seconds, not the next morning
The lead qualified and scored from what they wrote; the first reply sent immediately in their language
E-mail verified (syntax, domain, deliverability) before anything is promised to it
Contact record created; the owner alerted; the next step proposed
Forms translated into your customers' languages; embedded on any site
Feeds every automation you add: booking, quoting, follow-up, the AI Demo

Available on its own or inside a solution · See pricing › · Per company, never per seat.

Everything AI Web Forms does, for every business ›

Works withAI Booking AI Quoting AI Follow-up AI Demo AI Tickets AI File Cabinet

What it does

Home care referral form and inquiry form, answered on the spot

Up to five questions of yours

Ask where care is needed, how soon, the relationship to the client and the payer named, as text, a choice, a date or yes or no.

Screening rules

A rule reads an answer: a discharge today marks the form URGENT for intake, and the desk is told while the family already has its reply.

The next step you chose

A free assessment slot from your booking page, a call back from your line, a guide to your services or simply an alert to the intake desk.

Spam never shows

A hidden field and a limit per network keep bots out of the referral list, so intake reads only real families and case managers.

Moments

Lead management for home care providers, from the first form

A form on Saturday night

The family gets the reply at once, the contact lands in AI CRM, and the follow-up plan for a new inquiry starts by itself.

Forms in their languages

Add the language codes and the AI translates your inquiry form, so a family reads and fills it in Spanish, Tagalog or Russian.

A care guide behind the form

Choose a guide as the next step and the family receives your care guide only after clicking the link that confirms their e-mail address.

Questions & answers

Online intake form questions from home care agencies

How fast should a home care agency answer an online inquiry?

At once, because families often send several agencies the same form. AI Web Forms replies on the spot, in the family's language, says what happens next and can offer free assessment times, while the inquiry lands as a contact for intake.

Can the home health referral intake form flag an urgent hospital discharge?

Yes. A screening rule reads an answer, such as a discharge date of today, and marks the form URGENT: the intake desk is told at once, or the first free slot on your booking page is offered to the sender.

Does the form check that a case manager's e-mail is real?

You tick the checks per form. On a referral form, a company e-mail and a verified e-mail fit well; on the family or senior living inquiry form, which often comes from a personal mailbox, leave the company e-mail check off.

Is consent asked on the inquiry form?

When the form asks for a phone number, it also asks the family's consent to receive texts. The answers land on the contact's story in AI CRM, beside their calls and e-mails.

How is the form added to our website?

Copy one line and paste it where the form should appear, inline, as a popup or as a compact row, or hand the line to whoever edits your site. Your webmaster needs no login.

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